Cañete, Baby Girl .

HRN: 29-23-02  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/27/2026
AMPICILLIN 250MG (VIAL)
06/27/2026
07/04/2026
IV
45mg
Q 12
Prematurity
Checking Initial Appropriateness 
06/27/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
06/27/2026
07/04/2026
IV
4mg
Q 36
Prematurity
Checking Initial Appropriateness 
06/30/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
06/30/2026
07/06/2026
IV
14mg As LD Then 7mg IV Q12
Q12
T/C NEC
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: